2010 Session

Budget Amendments - HB30 (Member Request)

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Chief Patron: Jones
Medicaid Improvements for End Stage Renal Disease & Chronic Kidney Disease

Item 297 #16h

Item 297 #16h

First Year - FY2011 Second Year - FY2012
Health And Human Resources
Medical Assistance Services, Department of FY2011 ($4,000,000) FY2012 ($4,000,000) GF
FY2011 ($4,000,000) FY2012 ($4,000,000) NGF

Page 196, line 50, strike "$6,806,326,159" and insert "$6,798,326,159".
Page 196, line 50, strike "$7,272,405,030" and insert "$7,264,405,030".
Page 209, after line 23, insert:
"XXX.  The Department of Medical Assistance Services shall partner with one or more appropriate vendors to improve clinical outcomes and achieve Medicaid savings through enhanced coordination of care for that portion of Medicaid enrollees identified with end stage renal disease (ESRD) or chronic kidney disease.  Any agreement between the Department and any vendor(s) shall only provide compensation for vendor(s) out of identified savings reasonably attributable to the scope of work performed by the vendor in providing the enhanced coordination of care.  The Department shall ensure that the services provided are directed at (i) delaying the progression of kidney disease and reducing avoidable costs such as the use of emergency rooms for ESRD diagnosis; (ii) improving transplantation rates in the Commonwealth; (iii) preparing patients for dialysis, including a focus on the modality for which they are most suitable and fistula placement in accordance with the Fistula First Breakthrough Initiative through the Centers for Medicare and Medicaid Services (CMS); (iv) assisting patients with adapting to dialysis; and (v) providing education and taking on care coordination issues such as nutrition, medication, management, and immunizations."

(This amendment reduces Medicaid funding by $4.0 million in general fund amounts and $4.0 million in federal matching Medicaid funds from savings achieved through requiring one or more vendor to improve clinical outcomes through better care of Medicaid recipients with end stage renal disease or chronic kidney disease. )